This inflammation of the eyelids is the most common cause of dry eyes. It can result from:

• An excess growth of bacteria that’s normally found on your skin
• A blocked oil gland on your eyelid
• A hormone imbalance
• Allergies

What Are the Symptoms?

It makes your eyelids red, itchy, and a little swollen. The bases of your eyelashes may also look scaly. You might also notice:

• Feeling like something is in your eye
• A burning feeling in the eye
• Sensitivity to light
• Red and swollen eyes or eyelids
• Blurry vision
• Dry eyes
• Crusty eyelashes

How Is Blepharitis Treated?

There is no cure. But it can be treated and controlled. Just take care of your eyelids. If you don’t treat blepharitis, it could scar or injure your eye.

If you have blepharitis, take the steps listed below to help cleanse your eye:

• Wet a clean washcloth in warm (not hot) water.
• Wring it out and place it over your closed eyelids for 5 minutes.
• Rewet as necessary to keep it warm. This will help soften crusts and loosen oily debris.

If your doctor advises:

• Make a solution of half baby shampoo or mild soap, half water. Place the cloth over your index finger, dip it in the mix, and use it to clean your eyelid.
• Wash one lid at a time. Close the eye you’re cleaning. Rub the washcloth over your eyelashes and the edge of your lids for about 30 seconds to loosen clogged oils. Apply light pressure to squeeze out clogged oils from the glands behind your lashes.
• Rinse thoroughly with a clean, warm, wet washcloth. Pat dry.

If the blepharitis results from a problem with your oil glands, the doctor may suggest a testosterone cream to put on your eyelids. He may also suggest LipiFlow, a 12-minute procedure that gently heats clogged glands and applies mild pressure to “milk out” the oils.

Can I Prevent Blepharitis?

• Keep your eyelids clean.
• Remove all eye makeup before bedtime.
• Don’t use eyeliner on the back edges of your eyelids behind the lashes.
• If you’re in the early stages of treating blepharitis, you can prevent further irritation by not using makeup.
• Once you do start to use it again, replace products used in or near your eyelids. They may be contaminated.

Most often presenting as a keyhole-shaped pupil, coloboma may affect one or both eyes.

Persons with this problem of the iris often have fairly good vision, but those with it involving the retina may have vision loss in specific parts of the visual field, which can cause problems with reading, writing, and close-up work or play.

Large retinal colobomas, or those affecting the optic nerve, can cause vision loss that cannot be completely corrected with glasses or contact lenses.

This eye condition is estimated to occur in about one in 10,000 people. It is typically discovered at birth, although it does not always affect vision or the outward appearance of the eye.

Because this condition can be associated with other health conditions affecting the eye and other parts of the body, careful evaluation and monitoring of a child with coloboma is important. Although symptoms can be managed, there is currently no cure for the condition.

Symptoms of Coloboma:

Persons with an isolated coloboma may have normal vision and no symptoms, or they may have mild to severe vision impairment. How vision is affected depends on where the gap or gaps occur in the eye. Symptoms may include:

• Keyhole-shaped pupil
• Light sensitivity or photophobia (usually occurs with iris coloboma)
• Vision impairment or loss that may not always be correctable

What Other Conditions Are Associated With Coloboma?

Coloboma may occur by itself — which is described as nonsyndromic or isolated. It may occur with other conditions or as part of a syndrome that affects other organs and tissues in the body. Some people with coloboma have associated eye abnormalities, including:

• Microphthalmia – one or both eyeballs are abnormally small
• Anophthalmia – no eyeball forms at all
• Cataract – clouding of the lens of the eye
• Glaucoma – increased pressure inside the eye that can damage the optic nerve
• Vision problems such as nearsightedness (myopia)
• Nystagmus – involuntary back-and-forth eye movements
• Retinal detachment – separation of the retina from the back of the eye
• Eyelid coloboma – gaps that occur in the eyelids are also called colobomas, but they arise from abnormalities in different structures during early development

Ocular Coloboma may be a feature of the following syndromes:

• Renal coloboma Asyndrome – characterized by optic nerve dysplasia and renal hypodysplasia
• CHARGE syndrome – characterized by coloboma, heart defects, atresia, retarded growth and development, genital hypoplasia (undescended testicles), and ear abnormalities
• Cat eye syndrome – characterized by coloboma, anal atresia, and an extra chromosome
• Morning glory syndrome – optic disc coloboma that may be accompanied by cranial facial, neurologic, and other symptoms

What Causes Coloboma to Develop?

The bottom line is, it results from abnormal development of the eye during the third trimester of gestation, when the eye is forming. The defect occurs when the optic fissure does not close completely. Its location depends on which part of the optic fissure fails to close.

Coloboma may occur spontaneously or it may be inherited. Persons with isolated coloboma can still pass the condition onto their children.

When it occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition.

Environmental factors that affect early development, such as the exposure to alcohol and certain drugs during pregnancy, may increase the risk of coloboma.

How is Coloboma Diagnosed in Adults and Children?

Coloboma is often identified at birth by hospital staff, or by a parent who may notice something different about their baby’s pupil. A baby will be evaluated by an ophthalmologist who will perform a complete eye examination to determine how much of the eye is affected.

The examination typically involves use of an ophthalmoscope to look inside the baby’s eyes. The baby may be given a general anesthetic to avoid causing any distress during the examination. At this age, it is difficult to tell whether the baby will have vision problems.

A child with coloboma will be monitored closely by their ophthalmologist, and their vision will be tested on a regular basis.

In addition to an eye examination, a baby may undergo other testing to see whether any associated conditions are present, and to check his or her general health. The families of affected children may be referred for genetic counseling.

For the child with an isolated coloboma, this may involve an evaluation to determine the risk of recurrence. A child with a genetic form or a specific syndrome of which coloboma is a part, may be referred for certain genetic tests.

How Can I Manage My Coloboma?

You may not require treatment unless it is causing vision problems. If the child with a coloboma is healthy and has no other eye conditions or complications, then the recommendation may be an eye test every six months up to the age of seven years and then annually thereafter.

The purpose of the eye tests is to monitor the effect of the condition and the child’s eye health. Frequent monitoring of children with this condition is important because of the potential for the development of associated eye conditions, such as glaucoma and retinal detachment.

As children with coloboma get older, they may become concerned about the appearance of their eyes. Cosmetic contact lenses can help make the pupil look round rather than keyhole-shaped.

For children with light sensitivity, tinted glasses, sunglasses, wide-brimmed hats, and sunshades in cars can help reduce discomfort caused by bright lights or the sun.

 

Retinitis is a disease that threatens vision by damaging the retina — the light-sensing tissue at the back of your eye. Although there’s no cure, there are steps you can take to protect your sight and make the most of the vision you have.

Types of Retinitis

Retinitis pigmentosa (RP). This is a group of genetic eye diseases you inherit from one or both parents.

Some examples of RP and related diseases:

• Usher syndrome
• Leber’s congenital amaurosis (LCA)
• Rod-cone disease
• Bardet-Biedl syndrome

CMV retinitis. This is a type of retinitis that develops from a viral infection of the retina.

CMV (cytomegalovirus) is a herpes virus. Most people have been exposed to the virus, but it usually causes no harm. When a herpes virus is reactivated in people with weaker immune systems, it can cause retinitis.

 

Symptoms of Retinitis

Symptoms of RP. You’re most likely to get a diagnosis of RP as a teen or young adult.Vision loss is slow, and the rate of vision change varies from person to person. How quickly it moves depends on the genetic makeup of your RP.

• Early RP symptoms: Loss of night vision, making it harder to drive at dusk or night or to see in dimly lit rooms.
• Later RP symptoms: Loss of side (peripheral) vision, leading to tunnel vision — like looking through a straw.

Symptoms of CMV retinitis. In early stages, CMV retinitis causes no symptoms.

You may develop symptoms, first in one eye, over a few days.

Symptoms may include:

• Floaters (specks or clouds in your field of vision)
• Blurred vision
• Loss of side vision

Just as with RP, symptoms may occur first with central vision. This affects reading and perception of color.

Treatment

If you have retinitis, it’s important to see an eye doctor (ophthalmologist) regularly.

Treatment for RP. Supplements may slow the disease. Research has shown some promise with a combination of vitamin A, lutein, and oily fish high in the omega-3 fatty acid DHA.

Fish high in omega-3 fatty acid include:

• Salmon
• Tuna
• Sardines

Ask your eye doctor how much vitamin A is safe to take. In high levels, it can be toxic.

It may also help to wear sunglasses to protect your eyes from ultraviolet (UV) light.

Researchers are looking into a range of treatment options, such as stem cells, medications, gene therapy, and transplants. They are already making progress. For example, patients in a small genetic study have had some sight restored with genetic therapy. One day, it may be possible to treat RP by inserting healthy genes into your retina.

If you have RP, there are some devices that can help make objects look brighter and larger, such as low-vision magnifiers. These devices can help you remain independent and active.

You can also try rehabilitation services that can help you use the vision you have in a more effective way.

Treatment for CMV retinitis. To help prevent blindness, doctors both treat the retinitis and work to strengthen your immune system.

You may need an antiviral medication such as ganciclovir. You might take pills by mouth or receive an injection into a vein or eye.

 

You may feel like your eyes have a mind of their own. They move up and down, side to side, or in a circle. This is called nystagmus or “dancing eyes.” It’s a condition where you can’t control your eye movements.

What Causes Nystagmus?

It may be a sign of another eye problem or medical condition. You may be born with it, or you might develop it later in life. Nystagmus is caused by many different things, including:

• Being passed down from your parents
• Other eye issues, like cataracts or strabismus
• Diseases like stroke, multiple sclerosis, or Meniere’s disease
• Head injuries
• Albinism (lack of skin pigment)
• Inner ear problems
• Certain medications, like lithium or drugs for seizures
• Alcohol or drug use

Sometimes, your doctor may not know what causes it.

What Are the Symptoms of Nystagmus?

Your eyes move without your control. It might be fast, then slow, then fast again. The movement might be in one eye, but it’s usually in both eyes. You may notice that you nod your head or keep it in strange positions. You do that because it helps you focus when you can’t hold your gaze steady. Things look clearer when you tilt or turn your head.

Objects may seem a little blurry to children with nystagmus. But the world doesn’t look shaky to them. It’s different if you develop the condition as an adult. Then the world appears to move a little when you look around.

Nystagmus may also affect your vision. You might have a hard time seeing in the dark, or you may be sensitive to bright light. You may have problems with balance and dizziness. These can be worse if you’re tired or stressed.

How Do You Treat Nystagmus?

If you developed nystagmus as an adult, there may be simple things you can do to lessen its effects. Sometimes you may just have to stop a medicine or quit drinking alcohol or taking drugs.

Wear the right contacts or glasses to improve vision. It won’t cure nystagmus, but it can help with other eye problems that can make it worse.

Eye muscle surgery may be an option. The goal is to help with the head tilt that often comes with nystagmus. Sometimes surgery improves vision, too.

Some drugs may ease symptoms in adults but not children. These include the anti-seizure medicine gabapentin (Neurontin), the muscle relaxant baclofen (Lioresal), and Botox.

There are things you can do at home to make it easier to deal with your “dancing eyes.” Use large-print books and turn up the print size on your computer, tablet, and phone. More lighting may help with vision, too.

If your child has nystagmus, encourage her to use her eyes. Big and brightly colored toys are easiest to use. Choose toys that make noise and have unique textures.

Let your child hold books close to her eyes with her head tilted. Let her wear a hat or tinted glasses — even indoors — to reduce glare.

Talk to your child’s teacher to make things easier at school. It would be hard for her to share books or papers. Let her choose where to sit so she can see the board and the teacher.

Causes of Tunnel Vision

The list of possible causes for loss of peripheral vision is a long one, so this article should by no means be taken as an exhaustive list. If you find you have experienced a decrease in your peripheral vision, it is important that you see an eye doctor as soon as possible in order to obtain a diagnosis and find out what treatment options may be available to you.

Glaucoma

Glaucoma is one of the leading medical causes of tunnel vision. This insidious disease is caused by a buildup of pressure inside the eye (which itself can have any number of causes), which eventually begins to cause damage to the optic nerve. When this happens, blind spots begin to appear on the affected person’s field of vision.

Open-angle glaucoma, the most common type, is also the form of glaucoma most likely to cause tunnel vision. This is because the blind areas in the visual field caused by open-angle glaucoma tend to appear first at the edge of the affected person’s range of sight.

If you believe you are experiencing any of the symptoms of glaucoma—which include (in addition to tunnel vision) cloudy or blurred vision, severe eye pain, halos around lights, and nausea/vomiting, it is important that you seek medical attention as soon as it is possible to do so.

Retinitis Pigmentosa

Retinitis pigmentosa is a progressive disease that causes the death of the rods and cones—the light-sensitive cells in your retina that pick up visual information and transmit it to your brain. This causes a gradual loss of vision, which often begins with peripheral vision loss.

Unfortunately, the cause of retinitis pigmentosa is not known (although it is suspected to be genetic), and there is no cure.

Blood Loss Due to Injury

Under certain circumstance, the rapid loss of a large amount of blood can result in a loss of peripheral vision.

Alcohol Intoxication

Drinking too much alcohol can cause a variety of visual symptoms, including blurred vision and double vision. While it is less common, alcohol intoxication can on occasion cause tunnel vision.

Of course, this is a subjective experience; in many cases of alcohol-induced peripheral vision loss, the likely explanation is that the intoxicated person is simply suffering from a decreased awareness of their surroundings, and a correspondingly decreased ability to react to them. In short, a drunk may have his peripheral vision and simply be too intoxicated to pay any attention to it.

Hallucinogenic Drugs

Hallucinogenic Drugs come in a great many varieties: LSD (aka “acid”), psilocybin (aka “magic mushrooms”), ecstasy, peyote buttons, Mexican Moonshot Capsules, Squid Juice, Midnight Deathtrap Music, Symbionese Liberation tablets—the list is endless.

What most of the chemical concoctions have in common is their ability to alter the user’s perceptions and cause visual hallucinations—which can sometimes include tunnel vision. One reason for this may be that a person who is “tripping” on psychedelic drugs may become intensely focused on whatever has captivated his attention—say, a pebble or an insect. This narrowing of mental focus creates the sensation that object being focused upon is the only thing in the world, a perception that may manifest itself as tunnel vision.

While experimenting with so-called “psychedelic” drugs may seem like fun, it is not a practice recommended by most mental health professionals. Your brain is not a toy; it is one of the more important organs in your body, and needs to be treated accordingly.

Medications

Leaving aside the effects of alcohol and recreational psychedelics, more mundane drugs can also sometimes cause tunnel vision. Medications such as brimonidine, nitroglycerin, and scopolamine, among many others, list peripheral vision loss among their side effects. Always consult with your doctor and your pharmacist about potential side effects before beginning any course of medication.

Concussion or Stroke

Over half a million Americans suffer strokes each year. The symptoms of a both conditions include dizziness, feelings of confusion, and various visual disturbances, including peripheral vision loss. The reason for this is that stroke and concussion are both negative events affecting the brain (a stroke occurs when blood flow to the brain is blocked, depriving the brain of oxygen and nutrients).

Choroideremia

Choroideremia is an extremely rare genetic condition that causes sufferers to slowly lose their vision. It affects men almost to the exclusion of women, and symptoms usually begin to manifest during childhood.

Sufferers of choroideremia find their vision slowly dimming over a period of years, and eventually their peripheral vision begins to disappear.

Retinal Detachment

Retinal detachment occurs when the retina—the layer of light-sensitive cells at the back of the eye—peels away from the back of the eye, in much the same way that an orange peel disengages from the fruit.

Visual symptoms of retinal detachment include flashes and floaters in the peripheral vision area, and the visual field can sometimes narrow, causing peripheral vision loss.

Retinal detachment is a serious, vision-threatening emergency. If you think you may be experiencing any of the symptoms of Retinal detachment, see an eye doctor as soon as you possibly can.

Panic Attack

Many people are subject to panic attacks. This is not a character weakness; it is a medical condition with both psychological and physiological causes.

Among the symptoms of panic attack are derealization, which is defined as a feeling of unreality, and depersonalization—a sense of detachment from oneself. With these sensations can come a range of vivid perceptions of altered reality, including tunnel vision.

Cataracts

A cataract occurs when some of the protein that makes up the lens of your eye begins to clump together, causing a cloudy area in your field of vision. Often cataracts form in the center of the lens (this is called a nuclear cataract), but in many cases cataracts form around the edges of the lens, causing peripheral vision loss.

Ocular Migraine

Ocular migraines are not the same as the migraine headaches that you or someone you know may experience from time to time. In fact, an ocular migraine is often painless.

A person who suffers an ocular migraine will, for ten to twenty minutes, experience shimmering “scintillations” in their visual field, possibly accompanied by halos around objects and a loss of peripheral vision.

Fortunately, ocular migraines are harmless, and the sensation of tunnel vision and other symptoms abate within minutes.

Mercury Poisoning

Mercury is a highly poisonous substance, and mercury poisoning can happen in a variety of ways. Industrial pollution is one of the more common causes of mercury poisoning, but equally common—and more widely known about—is overconsumption of mercury-contaminated fish or whale meat.

Many of the symptoms of mercury poisoning are neurological in nature—itching, burning, or the sensation of insects crawling on one’s skin—and visual disturbances such as tunnel vision can certainly accompany these types of symptoms.

Snake Bite

There are many, many different varieties of poisonous snake in the world, with many different types of venom. The type of snake venom that concerns us here is neurotoxic venom. This is any snake venom that acts on the nervous system. The neurotoxins in snake venom produce a number of unpleasant effects, including trouble swallowing, respiratory failure, and peripheral vision loss.

Which variety of snake is most likely to be armed with neurotoxic venom? Elapid snakes, i.e., cobras. There are exceptions, however—the venom of the Mojave rattlesnake is also highly neurotoxic. If you enjoy hiking or other such outdoor activity, it is important to exercise caution: always wear long pants and sturdy boots, and watch the trail carefully.

Risks Associated with Peripheral Vision Loss

The loss of one’s peripheral vision, even if temporary, can present immediate and long-term safety hazards. Without our peripheral vision, we are unable to perceive dangers that are not directly in front of us.

The most important thing to remember is that never, under any circumstances, should you drive a car if you are experiencing tunnel vision. This cannot be stressed enough. It is likewise important that you not ride a bicycle with tunnel vision, especially in vehicular traffic.

If you must go somewhere on foot, and your peripheral vision is impaired, the wisest and safest course of action is to ask a friend or family member to accompany you on your errand. Take your friend’s arm and hold firmly but loosely onto their elbow or bicep. Your companion will serve as an additional pair of eyes, ensuring that you are not blindsided by oncoming cars or bicycles that you are not able to see due to your tunnel vision.

Also, while this should go without saying, it bears mentioning that if you have a job that involves physical labor, especially if it requires you to use potentially dangerous tools or heavy machinery, you must take a leave of absence from that job until your normal peripheral vision has been restored. If your tunnel vision is permanent for any reason, a career change or an application for disability payment may be in order.

Likewise, if your hobbies include sporting activities such as baseball, basketball, boxing, or—most especially—target shooting, you must abstain from these activities until your tunnel vision has cleared up.

Treatment for Tunnel Vision

The correct treatment for a case of peripheral vision loss depends entirely on the cause of the condition. The articles on our site linked from the “Causes” section above can shed light on what (if anything) can be done to treat your particular case of tunnel vision.

Male Hormone Imbalance

Male hormone imbalance is a growing problem, I am testing more and more men with less than optimal testosterone results, often combined with high estrogen. There are some simple diet, lifestyle and supplement options that you can do to help optimise your hormonal health, but the first thing I recommend doing is testing your hormones.

Signs and Symptoms of Excess Estrogen

You do not need to have all of these symptoms if you have excess estrogen, these are the most common symptoms that men experience.

• Low testosterone and excess estrogen can cause similar symptoms in men

• Excess estrogen can cause excess weight, especially around the breasts, hips and abdomen and is the most common male hormone imbalance in overweight men.

• Excess estrogen can lead to low libido, infertility and erectile dysfunction

• Increased risk of stroke and heart attack because of an increased risk of clotting

• Increased risk of prostate cancer

Signs and Symptoms of Low Testosterone

Low testosterone has many similar symptoms to excess estrogen, with more muscle weakness and fatigue being the main difference.

• Similar to excess estrogen, low testosterone can cause low libido and erectile dysfunction.

• Muscle weakness and poor recovery from exercise.

• Fatigue and lack of energy, this can be caused by many things and low testosterone is one of them.

• Mood changes and depression.

• It can lead to weak bones and osteoporosis as you age.

 

What Causes Low Testosterone and Excess Estrogen

There are many different causes of hormonal imbalances in men and here is a list of the most common ones.

• Stress can cause many different health problems and hormone problems are no different, adrenal fatigue will upregulate an enzyme called aromatase leading to low testosterone and high estrogen.

• Diets high in refined carbohydrates will lead to insulin resistance and problems with the sex hormones.

• Excess weight leads to excess estrogen, many men with excess abdominal weight will be high in estrogen.

• Personal care products can be high in chemicals which contain xenoestrogens.

• Other chemicals in the environment and plastic containers also contain xenoestrogens leading to higher estrogen levels and lower testosterone levels.

• Excessive amounts of cardio/ endurance exercise will lead to a drop in testosterone and higher estrogen, strength and high intensity interval training is a better option.

• Excess alcohol will lead to lower testosterone.

Supplements

These are some of the supplements that I recommend and that I have seen client get good results with, the supplements that you need will depend on whether you have high estrogen levels or low testosterone. There are also different causes of the hormones going out of balance which is why I recommend the DUTCH hormone test to help identify exactly what is going wrong.

Eye dystonia (the medical term is Blepharospasm) is uncontrollable and often painful muscle contractions around the eye. Symptoms of eye dystonia may include excessive blinking and involuntary closure of the eyelids. The cause is believed to be incorrect messages from the brain to the muscles around the eye. Eye dystonia is a neurological movement disorder and should be diagnosed and treated by an ophthalmologist or a neurologist specialising in movement disorders.

Blepharospasm usually starts gradually. First symptoms may include eye irritation, sensitivity to light and increased blinking. The frequency and severity of the muscle spasms generally increases over a period of one to two years. Sometimes eye dystonia is experienced together with mouth, jaw or tongue dystonia (oromandibular). The medical term for this is Meige’s syndrome.

Causes:

The cause of dystonia is not fully understood. There appears to be a problem with the region of the brain called the basal ganglia. In most cases where dystonia appears in adults and some case where it appears in children, there is no clear explanation for why this problem arises.

However, in a minority of cases, the dystonia does have a clear cause. These are:

Another Medical condition

Where dystonias appear in children, in more than 80% of cases the dystonia will be secondary to another condition. In the majority of cases, this will be cerebral palsy.

Some dystonias appearing in adults may caused by stroke or tumour.

Drugs

Some dystonias, called Tardive, are caused by certain drugs (especially dopamine blocking drugs used to treat psychiatric disorders).

Genetics

Some cases generalised primary dystonia may be inherited.

 

Symptoms:

• Blinking and eyelid problems
• Neck problems
• Hand problems
• Voice problems
• Muscle spasms
• Tremor
• Dystonic Storms

Treatment usually involves regular injections, using a tiny needle, administered either by neurology or ophthalmology professionals and/or oral medication can also be prescribed. Some people find relief by applying light pressure to particular points on their face; symptoms can also be reduced by wearing dark glasses or wearing a hat with a peak. It is very much an individual experience.

Unfortunately there is not currently a cure. However, in the vast majority of cases, dystonia does not shorten a person’s life span. Most people do manage to develop successful strategies for living with dystonia combining treatment with pain control and sensory tricks.

Although there is currently no cure for dystonia, there are several widely used treatments. Many treatments are very successful but depend particularly on the type of dystonia and the age of onset. Because dystonia is such a complex and ‘individual’ condition, the usefulness of all these treatment options can vary widely between patients. Treatment regimes should be determined by a consultant familiar with dystonia.

Adult dystonia

The usual treatment regime for common forms of adult onset dystonia such as cervical dystonia, facial dystonia, oromandibular dystonia and blepharospasm is regular injections of botulinum toxin, which are usually repeated every three months.

Various oral medications drug treatments are available to assist in the management of some types of dystonia. However, not all medications are suitable for all people with dystonia.

In rare cases where cervical dystonia does not respond to botulinum toxin, Deep Brain Stimulation (DBS) brain surgery may be considered. Other surgical treatments which aim to either remove the problematic muscles or cut (denervate) selective peripheral nerves leading to these muscles, have also been found to be helpful for people with blepharospasm and torticollis respectfully.

Physiotherapy can be helpful to correct dystonic postures and movements in neck and hand dystonia. Speech and language therapy can be helpful if dystonia is affecting speech.

Young-onset dystonia

Many physicians will prescribe an initial trial of Levodopa for young patients as it can be highly effective in cases of dopa-responsive dystonia

Unfortunately, in the majority of cases, other oral drugs will be required of which Trihexyphenidyl is the most widely used. However, there are a number of other drug treatments available.

DBS brain surgery, especially in cases of generalised dystonia, can be of sustained benefit to certain young patients. Assessment will be required to determine whether DBS is suitable for individual cases. Botulinum toxin has limited use in the case of generalised dystonia as there are too many diverse muscles groups to treat successfully. It is used most successfully in the treatment of specific muscle groups.

Physiotherapy can be helpful to find the most effective way of coping with the dystonic movement. Speech and language therapy can be helpful if dystonia is affecting speech. An occupational therapist can help make adaptations to your approach to everyday life and make it easier to cope.

Acquired dystonia

Treatment of dystonia secondary to brain injury is often similar to that of young-onset dystonia. DBS is reported to be less successful in managing cases of secondary dystonia, as is botulinum toxin, although it can be useful when targeting specific small areas of muscle.

Physiotherapy can be helpful to find the most effective way of coping with the dystonic movement. Speech and language therapy can be helpful if dystonia is affecting speech. An occupational therapist can help make adaptations to your approach to everyday life and make it easier to cope.

For people with tardive dystonia (dystonia, which is a side effect to certain medications), the use of further medications to treat the symptoms of dystonia, needs to be managed very carefully.

Eye Floaters appear as small spots that drift through your field of vision. They may stand out when you look at something bright, like white paper or a blue sky. They might annoy you, but they shouldn’t interfere with your sight.

If you have a large floater, it can cast a slight shadow over your vision. But this tends to happen only in certain types of light.

You can learn to live with floaters and ignore them. You may notice them less as time passes. Only rarely do they get bad enough to require treatment.

What Are the Symptoms?

Floaters earn their name by moving around in your eye. They tend to dart away when you try to focus on them.

They come in many different shapes:

• Black or gray dots
• Squiggly lines
• Threadlike strands, which can be knobby and almost see-through
• Cobwebs
• Rings

Once you get them, they usually don’t go away. But you usually notice them less over time.

What Causes Them?

Most floaters are small flecks of a protein called collagen. They’re part of a gel-like substance in the back of your eye called the vitreous.

As you age, the protein fibers that make up the vitreous shrink down to little shreds that clump together. The shadows they cast on your retina are floaters. If you see a flash, it’s because the vitreous has pulled away from the retina. If that happens, see your eye doctor ASAP.

These changes can happen at any age, but usually occur between 50 and 75. You’re more likely to have them if you’re nearsighted or have had cataract surgery.

It’s rare, but floaters can also result from:

• Eye disease
• Eye injury
• Diabetic retinopathy
• Crystal-like deposits that form in the vitreous
• Eye tumors

• Detached retina
• Torn retina
• Bleeding in your vitreous
• Inflamed vitreous or retina caused by infections or an autoimmune condition
• Eye tumors

Something that might resemble a floater is the visual aura that can come with a migraine headache. It could look like what you see when you put your eye to a kaleidoscope. It might even move. It’s different from the floaters and flashbulb type “flashes” that come with other eye problems. This usually lasts a few minutes and may involve the vision in both eyes.

When to See the Doctor

If you only have a few eye floaters that don’t change over time, don’t sweat it.

Go to the doctor ASAP if you notice:

• A sudden increase in the number of floaters
• Flashes of light
• A loss of side vision
• Changes that come on quickly and get worse over time
• Floaters after eye surgery or eye trauma
• Eye pain

Choose a doctor who has experience with retina problems. If you don’t get help right away, you could lose your sight.

How Are Floaters Treated?

Benign ones almost never require medical treatment.

If they annoy you, try to get them out of your field of vision. Move your eyes — this shifts the fluid around. Look up and down, that usually works better than side to side.

If you have so many that they block your vision, your eye doctor may suggest surgery called a vitrectomy. He’ll remove the vitreous and replace it with a salt solution.

You might have complications like:

• Detached retina
• Torn retina
• Cataracts

The risk is low, but if these problems happen, they can permanently damage your vision.

What are styes and chalazia?

Styes and chalazia are lumps in or along the edge of an eyelid. They may be painful or annoying, but they are rarely serious. Most will go away on their own without treatment.

• A stye  is an infection that causes a tender red lump on the eyelid. Most styes occur along the edge of the eyelid. When a stye occurs inside the eyelid, it is called an internal hordeolum (say “hor-dee-OH-lum”).
• A chalazion  (say “kuh-LAY-zee-on”) is a lump in the eyelid. Chalazia (plural) may look like styes, but they are usually larger and may not hurt.

Styes and chalazia may be related to blepharitis, a common problem that causes inflammation of the eyelids.

    

 

 

What causes a stye or chalazion?

Styes are caused by a bacterial infection. Usually the bacteria grow in the root (follicle) of an eyelash. An internal hordeolum is caused by infection in one of the tiny oil glands inside the eyelid.

A chalazion forms when an oil gland in the eyelid becomes blocked. If an internal hordeolum doesn’t drain and heal, it can turn into a chalazion.

What are the symptoms?

A stye usually starts as a red bump that looks like a pimple along the edge of the eyelid.

• As the stye grows, the eyelid becomes swollen and painful, and the eye may water.
• Most styes swell for about 3 days before they break open and drain.
• Styes usually heal in about a week.

A chalazion starts as a firm lump or cyst under the skin of the eyelid.

• Unlike styes, chalazia often don’t hurt.
• Chalazia grow more slowly than styes. If a chalazion gets large enough, it may affect your vision.
• The inflammation and swelling may spread to the area surrounding the eye.
• Chalazia often go away in a few months without treatment.

How is a stye or chalazion diagnosed?

Doctors diagnose these problems by closely examining the eyelid. It may be hard to tell the difference between a stye and a chalazion. If there is a hard lump inside the eyelid, the doctor will probably diagnose it as a chalazion.

How are they treated?

Home treatment is all that is needed for most styes and chalazia.

• Apply warm, wet compresses for 5 to 10 minutes, 3 to 6 times a day. This usually helps the area heal faster. It may also help open a blocked pore so that it can drain and start to heal.
• Use an over-the-counter treatment. Try an ointment (such as Stye), solution (such as Bausch and Lomb Eye Wash), or medicated pads (such as Ocusoft Lid Scrub).
• Let the stye or chalazion open on its own. Don’t squeeze or open it.
• Don’t wear eye makeup or contact lenses until the area has healed.

If a stye is not getting better with home treatment, talk to your doctor. You may need a prescription for antibiotic eye ointment or eyedrops. You may need to take antibiotic pills if infection has spread to the eyelid or eye.

If a stye or chalazion gets very large, the doctor may need to pierce (lance) it so it can drain and heal. Do not try to lance it yourself.

How can you prevent styes and chalazia?

• Don’t rub your eyes. This can irritate your eyes and let in bacteria. If you need to touch your eyes, wash your hands first.
• Protect your eyes from dust and air pollution when you can. For example, wear safety glasses when you do dusty chores like raking or mowing the lawn.
• Replace eye makeup, especially mascara, at least every 6 months. Bacteria can grow in makeup.
• If you get styes or chalazia often, wash your eyelids regularly with a little bit of baby shampoo mixed in warm water.
• Treat any inflammation or infection of the eyelid promptly.

Ocular, or eye, melanoma is the most common type of eye cancer. It normally affects the uvea, the vascular layer of the eye between the retina and the white of the eye.

It is also known as uveal melanoma. Tumors develop in the melanocytes, the pigment-producing cells within the uvea that give color to the eye.

Most melanomas affect the skin, but some develop in other parts of the body, including the eye.

If cancer starts in the eye, this is primary eye cancer. If the eye melanoma starts elsewhere in the body and spreads to the eye, it is called secondary eye cancer.

Eye cancer is usually secondary, and 9 out of 10 eye melanomas start in the skin.

Signs and symptoms

Some patients may experience no symptoms, while others may have light flashes, blurring of vision, or see dark spots in their field of vision.

The following signs and symptoms are possible:

• a dark spot in the iris that gets bigger
• a displacement of the eye within the eye socket
• seeing flashing lights
• watery eyes>
• poor or blurry vision or loss of peripheral vision in one eye

There may also be floaters, or small specks or squiggles that move about in the patient’s field of vision. Floaters may be seen more clearly when looking at a plain background, such as a blank wall. They may appear as tiny dots, circles, lines, clouds, or cobwebs.

Floaters are common, especially as people age, and they do not necessarily indicate cancer.

Rarely, pain in or around the eye can be a sign of eye melanoma.

Causes and risk factors

Experts are not sure what the exact cause of ocular melanoma is, but genetic factors are believed to play a role in cells becoming cancerous.

Scientists have found links between eye cancer and some genetic changes, but it remains unclear exactly where these changes occur, or if they cause cancer to develop.

Risk factors

The following factors increase the chance of developing eye melanoma:

Eye color: People with blue eyes have a higher risk of developing melanoma of the eye than those with brown eyes.

Exposure to ultraviolet (UV) light: Exposure to UV light, for example from sunshine, may increase the risk, but research has not confirmed this.

Dysplastic nevus syndrome: In this condition, a person develops atypical moles, known as dysplastic nevi, which look different from ordinary moles. They have irregular borders, may be mixed in color, and appear in clusters. Dysplastic nevi are more likely to develop into malignant melanoma than ordinary moles.

Genetic factors: Some chromosomal abnormalities, such as those found on chromosome 3, increase the risk of melanoma spreading from the eye to other parts of the body.

 

Treatment and prevention

Treatment depends on several factors, including where and what type of tumor it is, the size of the tumor, and the patient’s general health.

If there is a small lesion, a doctor may suggest monitoring it rather than treating it straight away, as treatment can lead to some vision loss.

Surgery

A number of surgical options are possible.

Iridectomy removes parts of the iris with small melanomas that have not spread to other parts of the eye.

Iridotrabeculectomy removes parts of the iris and the supporting tissues where melanomas may have spread.

Iridocyclectomy removes part of the iris and ciliary body. The ciliary body is a thin layer between the white of the eye and the retina that contains blood vessels.

Choroidectomy removes part of the choroid, and sometimes part of the wall of the eye as well. The choroid is the pigmented, vascular part of the eye. The operation may be followed by a course of radiation therapy.

Enucleation removes the whole eye, in cases where the tumor is large, and any other treatment would result in the loss of most of the eye. It may also be recommended if there is eye pain.

The surgeon will implant an ocular prosthesis, or artificial eye. This does not provide vision. It is a cosmetic substitute.

Radiation and other targeted therapy

Radiation therapy can destroy the genetic material of cancer cells and stop them from reproducing. The radiation is carefully targeted to destroy the cancer cells while limiting damage to healthy cells. The doctor can deliver radiation from inside or outside the eye.

Two types of radiation treatment are teletherapy and brachytherapy.

Teletherapy generates radiation from outside of the patient’s body. It targets the malignant cells in the eye.

Brachytherapy temporarily anchors small radioactive seeds into the eye to shrink the tumor. The ophthalmologist or oncologist will stitch a plaque, or small implant, containing several iodine-125 seeds to the wall of the eye, near the tumor. It remains there for 4 to 5 days. The doctor carefully monitors the size of the tumor.

Transpupillary thermotherapy (TTT) is a type of infrared laser therapy that uses heat in the form of a laser to shrink smaller tumors.

Cryotherapy can freeze the cancerous cells.

Outlook and prevention

Treatment of eye melanoma is effective if it is detected and treated early enough. if the cancer only affects the eye, 80 percent of people will survive at least 5 years after diagnosis. If the cancer has spread to other parts of the body, around 15 percent will live for at least another 5 years.

Prevention

To reduce the risk of skin cancer and eye cancer, the American Cancer Society recommends using protection from strong sunlight, including sunglasses with UVA and UVB protection, sunblock, and a hat.

Sunshine and outdoor work have not been proven to cause eye cancer, but they may increase the risk.